- Most people with an enlarged spleen have no symptoms, and it is often found during a routine exam or imaging test.
- Possible symptoms include upper left abdominal pain, early fullness, fatigue, weight loss, or abdominal swelling.
- Severe pain with dizziness or confusion may signal a ruptured spleen and requires emergency care.
An enlarged spleen, also known as splenomegaly, occurs when the spleen becomes larger than normal due to conditions such as viral infections, liver disease, blood disorders, or cancer. Enlarged spleen symptoms may include pain in the upper left side of the abdomen or feeling full after eating only a small amount.
Most people with an enlarged spleen have no symptoms, and the condition is often found during a routine physical exam or imaging test. Additional blood tests or a bone marrow biopsy may sometimes be needed to identify the underlying cause.
Treatment for an enlarged spleen depends on the condition causing it and may include antibiotics, blood transfusions, chemotherapy, or, in severe cases, surgery to remove the spleen. A ruptured spleen is a medical emergency that can cause severe internal bleeding.
Enlarged spleen symptoms
The main symptoms of an enlarged spleen include:
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Pain or discomfort in the upper left side of the abdomen, which may spread to the left shoulder
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Feeling full after eating only a small amount
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Abdominal swelling
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Bleeding or red or brown spots on the skin
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Shortness of breath or difficulty breathing
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Excessive tiredness or a general feeling of being unwell
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Fever or chills
An enlarged spleen often does not cause symptoms and is usually found during routine testing. However, symptoms may appear as the spleen becomes larger.
Severe pain in the upper left side of the abdomen, especially when accompanied by confusion or dizziness, may indicate a ruptured spleen.
In these cases, immediate medical care should be sought at the nearest emergency room, as internal bleeding can occur and may be life-threatening.
Confirming a diagnosis
An enlarged spleen is diagnosed by a hematologist or primary care provider through a physical examination and diagnostic testing. According to the American College of Radiology, an abdominal ultrasound or CT scan may be used to evaluate suspected splenomegaly, while an MRI may also be appropriate. A Doppler ultrasound may be used to assess blood flow to and from the spleen.
The provider may also order a complete blood count (CBC), liver function tests, blood tests for infections, or autoimmune tests to help determine the cause. A bone marrow biopsy may be recommended when a blood disorder or certain cancers are suspected.
Possible causes
Some conditions that may cause an enlarged spleen include:
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Infections, such as mononucleosis, malaria, bacterial endocarditis, tuberculosis, HIV, or histiocytosis
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Autoimmune diseases, such as rheumatoid arthritis or lupus
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Cancer of the spleen or blood, such as leukemia or Hodgkin lymphoma
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Heart conditions, such as congestive heart failure
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Liver diseases, such as cirrhosis or hepatitis
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Injuries to the spleen
Other causes of an enlarged spleen include thrombocytopenic purpura, hemolytic anemia, thrombosis of the liver's portal vein, Felty syndrome, Gaucher disease, or Niemann-Pick disease.
An enlarged spleen may also be caused by sarcoidosis, amyloidosis, hemangioma, cancer that has spread from another part of the body, or cysts or abscesses in the spleen.
Treatment options
Treatment for an enlarged spleen depends on the underlying cause and may be managed by a primary care provider, hematologist, or another specialist. The goal is to treat the condition causing the spleen to enlarge and reduce the risk of complications.
Treatment may include antibiotics for bacterial infections, blood transfusions for anemia, or chemotherapy for cancer, depending on the underlying cause.
In more severe cases, a splenectomy (surgery to remove the spleen) may be recommended if the underlying cause cannot be treated or if complications develop, such as splenic rupture or severe hypersplenism. A splenectomy is usually performed laparoscopically, which generally allows for a faster recovery.
Possible complications
An enlarged spleen may lead to frequent infections, low levels of white blood cells, red blood cells, or platelets, anemia, or bleeding.
A ruptured spleen may also occur. This is a serious condition that can cause internal bleeding and may be life-threatening.